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目的观察益气养肝方联合干扰素、利巴韦林治疗慢性丙型肝炎的抗病毒疗效并探讨其机理,同时观察中药对干扰素不良反应的影响。方法选择慢性丙型肝炎气虚毒瘀型患者65例,随机分为益气养肝方联合干扰素、利巴韦林治疗组32例和干扰素、利巴韦林对照组33例,疗程均为6个月,治疗结束6个月时随访一次。观察症状、体征、生化指标、血清HCVRNA等的变化。结果治疗后两组抗病毒疗效比较,持续病毒学应答(SVR)、24周和48周时生化应答差异均有统计学意义(P<0.05)。治疗组血小板减少、粒细胞减少、体重减轻程度均较对照组轻,差异有统计学意义(P<0.05),干扰素其他不良反应如发热、肌肉关节酸痛、头痛、脱发等在两组间比较无明显差异。结论益气养肝方联合干扰素、利巴韦林治疗慢性丙型肝炎具有较好的临床疗效,血清ALT、AST、TBil改善以及持续病毒学应答均优于干扰素联合利巴韦林治疗,且对干扰素不良反应如骨髓抑制和体重减轻的发生有一定缓解作用。
Objective To observe the antiviral effect of Yiqi Yanggan Decoction combined with interferon and ribavirin in the treatment of chronic hepatitis C and to explore its mechanism, and to observe the effect of traditional Chinese medicine on the adverse reactions of interferon. Methods Sixty-five patients with chronic hepatitis C with qi deficiency and blood stasis syndrome were randomly divided into Yiqi Yanggan prescription combined with interferon, ribavirin treatment group with 32 patients and interferon plus ribavirin control group with 33 cases 6 months, followed up by 6 months after the end of treatment. Observation of symptoms, signs, biochemical parameters, serum HCVRNA changes. Results After treatment, the antiviral efficacy of the two groups were compared. After continuous virological response (SVR), there was significant difference in biochemical response between the two groups (P <0.05). The thrombocytopenia, neutropenia and weight loss in the treatment group were lighter than those in the control group (P <0.05). Other side effects of interferon such as fever, muscle and joint pain, headache and hair loss were compared between the two groups No significant difference. Conclusions Yiqi Yanggan Decoction combined with interferon and ribavirin in the treatment of chronic hepatitis C has good clinical curative effect. The improvement of serum ALT, AST, TBil and sustained virological response are superior to interferon combined with ribavirin, And the adverse reactions of interferon such as bone marrow suppression and weight loss have some relief.